Flashcards in EENT 9% Deck (81):
Inflammation of both eyelids =
Common in pts w/ ____.
Common in Down's syndrome, Eczema
Painful, warm, swollen red lump on eyelid
Tx: Warm compresses +/- topica abx (Erythromycin, Bacitracin)
I+D if no drainage after 48 hrs
PainLESS granuloma of internal meibomian sebaceous gland
Hard, non-tender eyelid swelling
Infection of lacrimal gland =
MC: S. aureus, GABHS, S. epidermis, H. flu, S. pneumo
Tx: Clindamycin + 3rd gen cephalosporin
Fleshy, triangular-shaped GROWING fibrovascular mass =
Associated w/ increased UV exposure in sunny climates
Yellow, elevated nodule on nasal side of eye (fat and protein) =
Orbital floor "blowout" fracture causes diplopia especially with ___ d/t ____.
inferior rectus muscle entrapment
Tx: Initial --> nasal decongestants, avoid blowing nose, prednisone
Abx (Unasyn, Clindamycin)
Positive Seidel's test seen in ___.
= parting of fluorescein dye by clear stream of aqueous humor from anterior chamber
Seen in ___.
small, round yellow-white spots on outer retina
Dry (atrophic) macular degeneration
Dx of wet macular degeneration =
Seen in ____
Scotomas = blind spots, shadows
Metamorphopsia = straight lines appear bent
Micropsia = object seen by affected eye looks smaller than in unaffected eye
Amsler Grid used for ___
management of DRY macular degeneration to monitor stability at home
Tx of WET macular degeneration
What can be used to slow progression of DRY macular degeneration?
Vit A, C, E, zinc
Presentation of Hypertensive Retinopathy based on stage
I: Arterial narrow --> Copper wiring (moderate), Silver-wiring (severe)
II: AV nicking
III: Flame shaped hemorrhages, cotton wool spots
IV: Papilledema = malignant HTN
patient's pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye =
Positive in ___ (2)
Positive in Papillitis, Retrobulbar neuritis
Seen in ___.
--> floaters* --> unilateral vision loss/shadow "curtain" in peripheral --> central visual fields*
Positive Schaffer's sign =
Seen in ___.
T/F: Normal or decreased intraocular pressure.
clumping of pigment cells in anterior vitreous
T/F: Acidic burns is worse than alkali burns.
False. Alkali burns are worse --> liquefactive necrosis
Tx: Immediate irrigation (Lactated Ringers, NS)
Broad spectrum abx (Moxifloxacin)
Infection of eyelid and periocular tissue =
T/F: Associated w/ visual changes and pain w/ ocular movement.
False: Associated w/ POSTseptal cellultis
Tx of Postseptal cellultis
Tx: IV Vancomycin, Clindamycin, Cefotaxime
Halo around lights, "steamy cornea", mid-dilated nonreactive pupil, eye hard to palpation seen in ___.
Acute narrow-angle closure glaucoma
Dx of Acute narrow-angle closure glaucoma
Increase IOP by Tonometry (>21 mmHg)
"Cupping" of optic nerve
1st line: Acetazolamide IV
Topical beta blocker: does NOT affect visual acuity
Miotic/cholinergics: Pilocarpine, Carbachol
Definitive tx: Peripheral iridotomy
Slow progressive Bilateral peripheral vision loss =
Chronic open angle glaucoma
1st line: Prostaglandin analogs (Latanoprost)
Viral conjunctivitis MC caused by ___ pathogen
Keratitis (A.k.a ____)
Bacterial presents w/ ____. Tx:
HSV presents w/ ____. Tx:
Bacterial: Hazy cornea
Tx: FQ (Moxifloxacin)
HSV: Dendritic lesions
Tx: Trifluridine, vidarabine, Acyclovir (ointment/PO)
MC etiology of Optic Neuritis
= inflammation of optic nerve CN II
PE: Marcus Gunn Pupil
Tx: IV methylprednisolone --> PO steroids
Anterior or posterior Uveitis?
Unilateral, ocular pain, redness, photophobia
Anterior or posterior Uveitis?
Ciliary injection (limbic flush), consensual photophobia, inflammatory cells and flare seen in ____
Anterior: topical steroids
Posterior: systemic corticosteroids
Pale retina w/ cherry-red macula (red spot)
Box car appearance of veins
Central Retinal ARTERY Occlusion
Blood and thunder appearance
Extensive retinal hemorrhages
Central retinal VEIN occlusion
____ artery commonly involved in Amaurosis Fugax
External carotid artery
Tx of Otitis Externa
- Neomcin/polytrim-B/hydrocortison (do NOT use if TM perforation if suspected)
MC cause of acute otitis media
If bullae on TM, suspect ___ as cause of acute otitis media.
Tx of Otitis Media
Drug of choice: Amoxicillin x 10-14 days
If PCN allergy: Erythromycin-Sulfisoxazole
Tx of mastoiditis
IV Abx (Ampicillin, Cefuroxime) w/ myringotomy
Refractory --> mastoidectomy
UNIlateral hearing loss is ____ until proven otherwise.
Acoustic (vestibular) CN 8 Neuroma
Management of Benign Paroxysmal Positional Vertigo
= canalith repositioning
Vestibular neuritis + hearing loss/tinnitus =
(Vertical/horizontal) nystagmus seen in central vertigo.
(Vertical/horizontal) nystagmus seen in pheripheral vertigo.
Weber lateralizes to (normal/affected) ear in sensorineural loss.
SensoriNeural lateralizes to Normal ear + Normal Rhinne
Weber lateralizes to (normal/affected) ear in conductive loss.
Rinne test has AC ( > or < ) BC in normal hearing.
AC > BC
Rinne test has AC ( > or < ) BC in sensorineural loss.
NORMAL: AC > BC
Rinne test has AC ( > or < ) BC in conductive loss.
AC < BC
X ray view to dx acute sinusitis
CT scan = diagnostic test of choice
Tx of acute sinusitis
Amoxicillin x 10-14 days**
Fungi that invades sinuses that may enter CNS
Affects orbits, sinuses, lungs, CNS
Tx: Amphotericin B, Posaconazole
____ associated w/ nasal polyps worse in AM
MC type of Rhinitis
MC infectious cause of rhinitis
MC type: Allergic = IgE mediated mast cell histamine release
Intranasal decongestants used > 3-5 days may cause ____
Rhinitis medicamentosa = rebound congestion
Sialolithiasis: Salivary stones MC in ___.
Wharton's duct (submandibular)
Stenson's duct = parotid glands
Oral lichen planus has increased incidence in pts/ with ___
Lacy leukoplakia lesions of oral mucosa
Oral lichen plancus
White patchy lesion that canNOT be rubbed off
T/F: 90% of oral leukoplakia are precancerous for dysplastic or evident of adenocarcinoma.
False. 90% of erythroplakia precancerous for SQUAMOUS CELL carcinoma
6% of oral keukoplakia are precancerous for squamous cell carcinoma
Oral hairy leukoplakia is caused by ____.
MC in pts with ____.
T/F: Can be scrapped off.
Epstein Barr Virus
False. Can NOT be scrapped off
T/F: Oral candidiasis can be scraped off but leaves behind erythema/bleeds.
Tx of RECURRENT aphthous ulcers.
Tx of peritonsillar abscess
Drainage + Abx (Unasyn or Clindamycin)
Tx of epiglottitis
IV Ceftriaxone +/- clindamycin
Rifampin for prophylaxis
Primary manifestation of HSV-1 in children
Acute herpetic gingivostomatitis
(6 mo-5 y/o)
Primary manifestation of HSV-1 in adults
Acute herpetic pharyngotonsillitis
Cellulitis of sublingual and sumaxillary spaces in the neck =
Swelling and erythema of upper neck and chin w/ pus on floor of mouth.
PCN + Metronidazole
Ramsay-Hunt Syndrome =
Herpes zoster oticus = acute facial palsy + otalgia and varicella or vesicular-type lesions.
Lesions on pinna**
Herpes varicella virus
Oral steroids, antiviral, pain medication
Hutchinson's sign =
Suggestive of ____
Involvement of tip of nose w/ herpes virus
Involvemnt of cornea w/ herpes --> urgent ophtho referral
Tensilon test (A.K.A. ___) used to dx ___
Myasthenia gravis (MG)
Permanent decrease in visual acuity in child caused by abnormal visual exposure during maturation process =
Hutchinson's incisors (notching of incisors) can be caused by ____.
"Tree branch" pattern on fluorescein stain
Herpetic infection of cornea = Herpetic keratitis
Otosclerosis causes (conductive/sensorineural) hearing loss
Bones of middle ear soften and then harden at joints
Presbycusis causes (conductive/sensorineural) hearing loss
= age related hearing loss
T/F: Myringosclerosis causes conductive hearing loss.
False. Scarring of TM does NOT cause hearing loss
CN3 palsy is frequently associated with ____
unruptured cranial aneurysm
Ptosis, dilated pupils, lateral deviation of eye, double vision
Painful gingivitis and stomatitis d/t spirochetal and fusiform bacterial infection
Enlargement skull compresses ____ in Paget's disease.
auditory nerve (CN8) --> neural deafness
Medications that may worsen psoriasis